First National Preventive Health Research Programme  YELP Holistic First Business Plan    YELP Holistic First Business Plan Defined Terms   SWOT Analysis   Executive Summary   Deliverables And Costs   Snapshot Page To 10 Benchmark Techniques   Defined Terms for Five YELP Business Plans

Second National Preventive Health Research Programme    Bohemian Teenagers Arts Assistance Programme      Defined Terms BTAAP

First BTAAP Business Plan      Bohemian Teenagers Show Choir Programme        Defined Terms BTSCP

Second BTAAP Business Plan    Bohemian Teenagers Symphony Orchestras Programme    Defined Terms - Bohemian Teenager Symphony Orchestra Programme

Third BTAAP Business Plan    Bohemian Teenager Ballet & Modern Dance Programme        Defined Terms BTB&MDCP

                                                               67 Coronga Crescent, Killara NSW 2071

0434 715.861

   (02) 9498.3684
 ScribePJ@Bigpond.com

 

DRAFT Newspaper article

 

Does the Preventive Health Taskforce possess skillset to alter lifestyles?

 

Two and a half years ago, on 9 April 2008, the Minister for Health & Ageing, Nicola Roxon, announced a seven member National Preventive Health Taskforce, Chaired by Dr. Rob Moodie, to provide evidence-based advice to government and health providers on preventive health programs and strategies.

The Taskforce's  Terms of Reference were -

a)         to provide a blueprint for tackling the burden of Lifestyle Related Chronic Diseases caused by Obesity, tobacco, and excessive consumption of alcohol - subsequently referred to as Three Public Health Risks; and

b)         directed at Primary Prevention to address all relevant arms of policy and all available points of leverage, in both the health and non-health sectors, in formulating its recommendations.

Inter alia, the Taskforce was to:

i)         inform what works and what doesn’t;

ii)        provide advice for policy makers on what strategies work best at a population level, and on the best buys for government investment in Primary Prevention; and

iii)       support the development of inter governmental and public-private partnerships on Preventive Health.

In Oct 2008 the Taskforce released a Discussion Paper which asserted "there is an urgent and immediate need to address the growing prevalence of obesity and overweight in Australia." and adopting a 'learning by doing' approach.

The Discussion Paper cited a recent US study Prevention for a Healthier America that estimated for every US$1 invested in "proven community-based disease prevention programs" (ie. increasing physical activity, maintaining a Healthy Diet and reducing smoking levels), the return on investment over and above the $1 per head cost of the program would be US$5.60 within five years.  

The Discussion Paper did not research the particular US study to use it as a precedent to similarly establish a community-based disease prevention program to achieve such high cost savings.  The Taskforce's Final Report titled "Australia: the healthiest country by 2020" dated 30 June 2009 to the Minister for Health & Ageing did not announce any new community-based disease prevention program.

In March 2010 the Medical Journal of Australia published a report by Professor Stephen Colagiuri, of University of Sydney, which identified the cost of Overweight and Obesity in Australia in 2004/2005 was $56.6 billion comprising:

*          Direct health care and other related costs totalled $21 billion

*          Government subsidies cost another $35.6 billion a year.

A report titled "The costs of tobacco, alcohol and illicit drug abuse to Australian society in 2004/05" by Collins and Lapsley estimated the cost of smoking and recreational drugs to be $56.1 billion in 2004-05.

Earlier this month, the Taskforce's deputy chairman, Mike Daube, announced that Obesity had overtaken smoking as the leading cause of premature death and illness in Australia.  Medical experts are claiming that the federal government is woefully unprepared for a tsunami of weight-related health problems.  "The obesity crisis is not on its way - it is already here," Professor Daube said. "What we have done about obesity is not working. This issue needs concentrated and determined action."

The Lifestyle Related Chronic Diseases from Obesity, smoking tobacco, and excessive consumption of alcohol very likely now cost the Australian economy in excess of $130 billion annually as the above two reports reviewed data in '04/'05 and did not extrapolate their findings to Australia's larger population of over 22 million in 2010.

Western television can make reality television of grossly Obese adults, who accept a challenge to lose significant body weight, into prime-time viewing because of the fervour and commitment the participants display to lose weight and change their Lifestyle Behaviour.  Yet with the resources of Federal Health at its disposal, after 2˝ years the Taskforce has not recommended commencing any new community-based disease prevention program, even though its Discussion Paper  -

(i)         acknowledged the enormous cost savings of such programs; and

(ii)        asserted "there is an urgent and immediate need to address the growing prevalence of obesity and overweight in Australia." and adopting a 'learning by doing' approach.

The closest the Taskforce's  Final Report has come is to "Establish, as part of the COAG Healthy Communities initiative, a national series of comprehensive five-year intervention trials in 10 to 12 communities (including low SES and Indigenous communities)".  But it did not provided a specification of what the interventions would be, the number of participants in each of 10 to 12 communities, budget costs or forecast benefits.

GPs have long been the front line treater of Obesity and related Diabetes.  The Federal Government has just announced that under a new optional “managed care” treatment package for diabetic patients, GPs who keep diabetic patients out of hospital may charge Medicare a $950 annual package fee, regardless of whether the treatment was related to their diabetes, or another problem such as a fever or broken leg.  A further $250 for allied health workers such as physiotherapists and dieticians, would be paid to those bodies.

In return for signing up to “personalised managed care plans,” patients suffering from Diabetes will forego their access to Medicare rebates for their Diabetes. 

Dr Chris Mitchell, president of the Royal College of GPs, told the media that GP clinics would have a “perverse” incentive to “minimise care” for patients.  "Practices would also have an incentive to sign on patients whose diabetes was well controlled and would need less care, while turning away others with advanced kidney disease or other complications."

In June 2007 "A new approach to primary care for Australia" by Jennifer Doggett from the Centre For Policy Development , which argued the merits of super clinics, noted that "There are few resources available for GPs and other primary care providers to work proactively to prevent the development of obesity in their community in the first place." 

The previous Coalition government's similar campaign was Focus On Prevention to treat Five Lifestyle Risk Factors For Chronic Diseases having also included unhealthy eating patterns and physical inactivity to the Taskforce's  Three Public Health Risks.  The Dept of Health & Ageing's focus on shifting emphasis within the health system away from managing the consequences of illness/disease, towards disease prevention and health promotion, is not a new phenomenon. 

Climate Change proponents contend an increasing health risk to future generations.  The InterGovernmental Panel on Climate Change pronounced in May 2007 that a "shift in lifestyles" was required to mitigate climate change.   Seven months later the IPCC were awarded the Nobel Peace Prize "for their efforts to build up and disseminate greater knowledge about man-made climate change, and to lay the foundations for the measures that are needed to counteract such change".  The Federal government is encouraging green friendly technologies, but what has it done about dramatically shifting Lifestyles in order to reduce carbon emissions?

Were the Taskforce's  Terms of Reference to arrest Obesity, smoking and excessive consumption of alcohol too narrow?  Certainly Lifestyle Related Chronic Diseases such as Type 2 Diabetes, lung cancer and liver cancer caused by the Three Public Health Risks are medical conditions.   However, prima facie Obesity, smoking and excessive consumption of alcohol are a function of Lifestyle Behaviour?  Has the Labor Government picked experts with too narrow a skillset to practically assist interested Australians to Materially Alter Lifestyle?  Should the Taskforce have also comprised a few Senior Business Executives with a track record of completing major projects, whose Lifestyle Behaviour includes Rigorous Recreational Exercise Activities.  These are Senior Business Executives whose lifestyle includes one or more of Hiking, Cycling, Kayaking, Ocean Swimming Triathlon, not because some advertising campaign warns of the perils of getting fat, but because they regard Challenging  Recreational Exercise Activities as Fun and Addictive  

If we do not want overweight Australians, shouldn't we be drawing on the mentoring skills and experience of some of the one in 500 Australians, aged between 50 and 60 - 5,100 approx - who over many years have successfully influenced lots of other Australians to the merits of their particular rigorous outdoor exercise within a Local Community Common Bond Support Group.  These are Australians who for many years have acted in voluntary sports administration roles for their chosen sport and possess explicit Sports Administration Attributes which include Walk The Talk Motivational Skills, Liability Risk Management Acumen and display a manifest Sense Of Community.  Drawing on some of these 5,100 or so healthy, fit Australians with the health runs on the board, who would be approaching retirement, if not recently retired, would seem a fillip for Kevin Rudd's Australia 2020 Summit selection of utilising the Gatekeeper attributes of Golden Gurus which, to date, hasn't had much impact.

A good summary of the Taskforce's Final Report titled "Australia: the healthiest country by 2020" dated 30 June 2009 to the Minister for Health & Ageing is at:

          Hawker Britton - Occasional Paper -  Preventative Health Taskforce Report: National Preventative Health Strategy  -  Sept 2009